17th January (Sunday)- A post I ran across while doing research. I don't know who the author is, but her Facebook name says Do Not Resuscitate
The surgeon is doing a tonsillectomy
on a 4 year old boy. Dr. Jones drops an instrument on the floor of the
OR. The instrument is now contaminated and has to be sterilized by a
special machine called an autoclave. This was a small hospital, so they
did not have a large inventory of duplicate surgical instruments. So the
circulating nurse put the instrument into the autoclave. As this
machine locked in with a special timer, they had to wait for the
sterilization process to be completed.
It was 2 minutes, then 3
minutes. The surgeon screamed at the nurse saying it was taking too
long. Dr. Jones stood up, having his sterile surgical gown and sterile
gloves on, and he picked up the steel stool he was sitting on and threw
the stool across the room and it crashed against the wall, as he
screamed obscenities. No one was hurt... physically, but it was a verbal
and a physical threat. This violent act or gesture was reported to
administration. All of the nurses knew the surgeon would get away with
it. He would never be reprimanded or put on probation. It all was swept
under that proverbial rug. Like nothing happened.
Or... The
circulating nurse placed an incorrect instrument onto the surgeon's
sterile table during surgery. The surgeon was so angry, that he picked
up his scalpel and threw it at the male circulating nurse. This scalpel,
this razor, missed the nurses face by 1/2 of an inch. The nurse pressed
charges. Eventually, the charges were dropped for insufficient
evidence.
Administration did not blink an eye.
Administration did not blink an eye.
Cathy was a timid nurse, but was the kindest nurse you'd ever want to take care of you.
She was very busy, as is the case in the Intensive Care Units. She was new to this hospital. Her other hospital did not have many patients on ventilators. This night was a heavy assignment. She had many IV drips running. Levophed, Vasopressin, Ativan, fentanyl and a pavulon drip. The patient had to be chemically paralyzed due to his asynchronous breathing with the ventilator. Cathy could have looked up this drug: Pavulon, but she saw 3 experienced nurses and so she asked them what were the indications of Pavulon.
First they ignored her as the 3 nurses 'huddled' together laughing. They didn't answer her.
So Cathy asked her question again. And outside of her patient's room, the three nurses started to laugh and talk about her. She heard them say out loud that she was stupid and how ridiculous it was for her to ask that question. That maybe she should take remedial nursing 101.
Cathy stayed in her patient's room, looked up the info on the computer , as a few tears slowly trickled down her face. She now knew that working in this most strategic, dynamic ICU, that she was on her own. Dangerously on her own.
A month passed, where she was shunned and ignored. She heard the nurses talk about upcoming weddings and baby showers and birthday parties of fellow staff members. She knew she wasn't invited... To anything. They basically treated her like she was invisible.
Cathy felt degraded, isolated, lonely and depressed. She felt that the group of nurses were so negative and aggressive, that she didn't have a chance to change the lateral violence in that unit.
Cathy transferred out of the ICU hoping she could find a place that was friendly and kind and encouraged team work.
She was very busy, as is the case in the Intensive Care Units. She was new to this hospital. Her other hospital did not have many patients on ventilators. This night was a heavy assignment. She had many IV drips running. Levophed, Vasopressin, Ativan, fentanyl and a pavulon drip. The patient had to be chemically paralyzed due to his asynchronous breathing with the ventilator. Cathy could have looked up this drug: Pavulon, but she saw 3 experienced nurses and so she asked them what were the indications of Pavulon.
First they ignored her as the 3 nurses 'huddled' together laughing. They didn't answer her.
So Cathy asked her question again. And outside of her patient's room, the three nurses started to laugh and talk about her. She heard them say out loud that she was stupid and how ridiculous it was for her to ask that question. That maybe she should take remedial nursing 101.
Cathy stayed in her patient's room, looked up the info on the computer , as a few tears slowly trickled down her face. She now knew that working in this most strategic, dynamic ICU, that she was on her own. Dangerously on her own.
A month passed, where she was shunned and ignored. She heard the nurses talk about upcoming weddings and baby showers and birthday parties of fellow staff members. She knew she wasn't invited... To anything. They basically treated her like she was invisible.
Cathy felt degraded, isolated, lonely and depressed. She felt that the group of nurses were so negative and aggressive, that she didn't have a chance to change the lateral violence in that unit.
Cathy transferred out of the ICU hoping she could find a place that was friendly and kind and encouraged team work.
Patty was a traveler nurse. And she loved it. She was able to travel to
different cities and states and practice her Emergency Department
Nursing specialty.
This ER was gigantic, and everything came through this door. Gun shot wounds, near suicides, heart attacks, any trauma, it was a smorgasbord for all ailments throughout this big city and beyond.
But Patty noticed that this ER lacked team work. The nurses basically shunned her and immediately she felt like an outsider instead of being an experienced nurse here to help them out.
She started to receive the worst assignments. The nurse- patient ratio was one nurse to four patients. Patty was given six patients at a time. All of the time.
When she called out for help, no one was there. When she needed help pulling up a 400 pound patient, no one was there. When she needed an RN to witness her mixing a vasopressin drip stat.... No one was there.
Patty could normally handle any situation, but now she felt overwhelmed.
She overheard a staff nurse say to the charge nurse: 'Well she makes all of that money. She can do it herself. Give her the worst'.
This ER was gigantic, and everything came through this door. Gun shot wounds, near suicides, heart attacks, any trauma, it was a smorgasbord for all ailments throughout this big city and beyond.
But Patty noticed that this ER lacked team work. The nurses basically shunned her and immediately she felt like an outsider instead of being an experienced nurse here to help them out.
She started to receive the worst assignments. The nurse- patient ratio was one nurse to four patients. Patty was given six patients at a time. All of the time.
When she called out for help, no one was there. When she needed help pulling up a 400 pound patient, no one was there. When she needed an RN to witness her mixing a vasopressin drip stat.... No one was there.
Patty could normally handle any situation, but now she felt overwhelmed.
She overheard a staff nurse say to the charge nurse: 'Well she makes all of that money. She can do it herself. Give her the worst'.
So where are the bullies?
They are everywhere. In the nursing workforce, they are in the OR , in the Emergency Dept, in ICU's, in floor nursing, in nursing homes and assisted living centers.
Who are bullies?
Bullies are older nurses who can be cruel to the younger nurses.
They are managers and directors that turn their backs on the nurses that plead for help.
They are physicians that belittle the nurses and put them down and are condescending to them.
They are younger nurses who feel like they have a special entitlement granted unto them, who have minimal experience but dictate to the older nurses that they are now old and 'in the way'.
They are the 'know-it- all' nurses who know everything and everyone else is stupid or 'special' . The list goes on and on. The situations and circumstances unfortunately are endless. And in the land of nurses being loving and caring and saving lives and being unselfish in all that they do, there is a percentage nationwide, universally that is destroying the core of what good nursing is all about.
They are everywhere. In the nursing workforce, they are in the OR , in the Emergency Dept, in ICU's, in floor nursing, in nursing homes and assisted living centers.
Who are bullies?
Bullies are older nurses who can be cruel to the younger nurses.
They are managers and directors that turn their backs on the nurses that plead for help.
They are physicians that belittle the nurses and put them down and are condescending to them.
They are younger nurses who feel like they have a special entitlement granted unto them, who have minimal experience but dictate to the older nurses that they are now old and 'in the way'.
They are the 'know-it- all' nurses who know everything and everyone else is stupid or 'special' . The list goes on and on. The situations and circumstances unfortunately are endless. And in the land of nurses being loving and caring and saving lives and being unselfish in all that they do, there is a percentage nationwide, universally that is destroying the core of what good nursing is all about.
What is the make-up of a bully?
Someone who may have low self-esteem, that it subconsciously makes them feel better to tear someone else down.
Someone who has narcissistic tendencies. They consider themselves infallible, above all others, including physicians.
Someone who has lived in a home environment and has learned to mimic
negativities such as harassment, shunning, ignoring, and laughing at others.
This behavior affects the entire unit. It reduces morale and the chain of comradery is broken.
Someone who may have low self-esteem, that it subconsciously makes them feel better to tear someone else down.
Someone who has narcissistic tendencies. They consider themselves infallible, above all others, including physicians.
Someone who has lived in a home environment and has learned to mimic
negativities such as harassment, shunning, ignoring, and laughing at others.
This behavior affects the entire unit. It reduces morale and the chain of comradery is broken.
60-80% of nurses nationwide have reported that at some time in their
nursing career, they have been bullied. Many leave that workplace, some
nurses leave their profession.
Nurses that are victims become detached, they second guess their skills, they become depressed and withdrawn...
Who can help?
Besides confronting that person, management would be the next in command. If management is ineffective, human resources would be next. But there is always a fear of retaliation.
Some institutions have a 'Zero tolerance' . This behavior is not accepted. EAP (Employee Assistance Program) is recommended for the victim and for the bully. EAP is a counseling service offered by many hospitals to their employees.
A probation period may be recommended for the bully.
Hospitals that implement Zero tolerance, have seen a 50 % change in the 'climate' of the unit, for the better.
Besides confronting that person, management would be the next in command. If management is ineffective, human resources would be next. But there is always a fear of retaliation.
Some institutions have a 'Zero tolerance' . This behavior is not accepted. EAP (Employee Assistance Program) is recommended for the victim and for the bully. EAP is a counseling service offered by many hospitals to their employees.
A probation period may be recommended for the bully.
Hospitals that implement Zero tolerance, have seen a 50 % change in the 'climate' of the unit, for the better.
If more institutions would implement 'Zero Tolerance' we could all get
back to caring and practicing what we love. And that is nursing.
Let's put a flashlight on the bullies. Make this end. Turn your units around, nationwide and get back to empowering each other, educating each other, coming together and learning from each other and helping one another with physical tasks, and emotional tasks. We are only good if we work together. For the sake of the unit, the nurses, the physicians, the technicians and most important: for the sake of the patients, let's come together and make nursing the greatest profession nationwide.
Educate, team work, empower...that's what makes a good nursing unit.
Let's put a flashlight on the bullies. Make this end. Turn your units around, nationwide and get back to empowering each other, educating each other, coming together and learning from each other and helping one another with physical tasks, and emotional tasks. We are only good if we work together. For the sake of the unit, the nurses, the physicians, the technicians and most important: for the sake of the patients, let's come together and make nursing the greatest profession nationwide.
Educate, team work, empower...that's what makes a good nursing unit.
On behalf of the majority of positive nurses, managers, physicians,
EMT's paramedics and technicians, I salute you all for relentlessly
doing some of the hardest tasks a job could have. This medical
profession is emotionally and physically challenging. We have to
constantly stay updated on medical terminology and protocols. Every day,
every minute is a new challenge. Saving lives is not an easy job. All
due respect for these medical professionals.
Reading this reminds me of my previous workplace. No pointing out names here, but I was a junior in a ward, very new at that time. Working life was a whole new world to me because I had never taken part time jobs at McDonald's or other restaurants, so I had zero experience of working life. Look back to my previous blogs of 2014 and you can see some of the ups and downs. I tried to refrain the bad part because I don't want people to think nursing is an awful job, but there are some.
Even till now, when I go outside and people ask me, "What's your profession?" And I trot out my standard answer, "SRN/ RN/ Staff Nurse." People give me that look. That look that says, "Uh...". Some just shake their head and go, "I never want to take up nursing. Always running after patients..." Or they just nod politely and take zero interest in your work. Of course everyone thinks it's an easy job, but I had encountered some of the nasty side of nursing, but I try not to let them hit me down.
After moving from my previous workplace, I was still unable to adjust due to the trauma. Eventually I got help from kind Sisters and was shifted to a new department, where people often isolate our department side. But being isolated doesn't mean it's a bad thing, our little department were like a family. We support each other, and surprise, surprise, the surgeons here are all super understanding type. Yes, I'm not joking. There's one who is a super grumpy type, and he tends to shout, but his heart is in the right place. You just have to look past his unsmiling, strict face.
On a day after 2016 ushered in, my two colleagues are on leave due to personal issues, so I had to run the department alone. All of our surgeons just came back, so you can imagine, with all of the patients pouring in too. And there was just me. My colleague had called for help before she went on leave and you know what they say, "Oh, we're short on staff. Sorry, you guys will have to work out on your own." !!!!! Now, I said our surgeons are understanding, but imagine if you have three surgeons who are all fighting for the treatment room, and there's only one of you. You got six patient stickers waiting, each of a different doctor and procedure. The only solution is for me to go two by two at a time, with different doctors. An example would be like this:
(Names are all not real to respect privacy and confidentiality of others)
1. Alex - Dr. Anderson
2. Harry - Dr. Skyler
3. Penny - Dr. Cho
4. Celia - Dr. Anderson
5. Elliot - Dr. Skyler
6. Guy - Dr. Cho
Instead of pushing all of the same doctors' patients in, you have to alternate. Like Dr Anderson in Room 1, Dr Skyler in Room 2. Once Dr Anderson is done, you push Dr Cho's patient into Room 1. And Dr Anderson to Room 2 once Dr Skyler is done and vice versa. That way you won't get stuck into any conflicts and you won't have the surgeons breathing fire down your throats. At that time, you can imagine I was running back and forth like the Mad Hatter. In between, when there's no procedures, I helped my cashier boy register patients. Because when he's busy taking payments and processing insurance letters, who is going to attend to the patients who are all impatiently waiting for their numbers to be called? And it was nearly half way through of my morning hour when they finally sent someone down, and that was after they changed the assigned person 3 times. Apparently they said a surgeon of ours is scary.
Now hold it right there. Remember I came down to this department last year, first as a temp, then to a full time staff. Never had I seen this surgeon yell or complain. No, when I wasn't sure of how to spray a certain solution to preserve the specimen, he gently took the canister from me and showed me how to spray correctly without damaging it. And few days ago when he was about to administer two injections, my friend and I were struggling with drawing Lignocaine because the syringe that we need to fill was the tuberculin syringe. The little ones that you usually use to administer insulin. The needle is so small, and the Lignocaine bottle is big. The surgeon laughed (not in a mean way) and instructed us to give the bottle a squeeze so that when you draw it actually goes into the syringe. See, that's why he's the doctor ^^
The surgeon that I often assisted, many people refused to assist him because they say he's strict, doesn't talk and smile. That's not true, I had worked with him for more than five months now, and he's a kind, sweet guy. When I sprained my ankle and overstrained my shoulder muscle, he nagged at me like a father to a daughter, instructing me that I should be more careful and gave me those anti-inflammation plaster patches and cream. Give him a chance, and you'll find that you can't get a better supportive doctor than him.
Okay, I think I ranted enough for this round. I need to rest my shoulder now, due to folding many red packets ornaments for the upcoming Chinese New Year. Can't wait. Yay...
